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General NPI Number Information
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NPI Number | 1972490605
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Entity Type | Organization
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Legal Business Name | RESILIENCE MEDICAL PC
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Dates
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Enumeration Date | 06/24/2025
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 120 SANTA MARGARITA AVE STE 210
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City | MENLO PARK
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State | CA
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Zip | 94025-2725
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Country | US
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Telephone | 833-775-6252
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 24661
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City | NEW YORK
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State | NY
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Zip | 10087-4203
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Country | US
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Telephone | 833-775-6252
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Fax |
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Authorized Official
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Title or Position | CCO AND CO-FOUNDER
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Name | CHRISTINE CARVILLE
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Credential |
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Telephone | 917-674-3421
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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